DThe number of hospital treatments continues to decrease. In the opinion of the health insurance companies, this indicates that in the past many referrals were superfluous and caused unnecessary costs. The clinics disagree with this finding.
As new data from the General Local Health Insurance (AOK) showed, the number of cases in normal, “somatic” houses fell by 15 percent in 2022 compared to the pre-Corona year 2019. In 2021 and 2020, the declines compared to the pre-Corona period 14 and 13 percent. In psychiatry, almost 11 percent fewer cases were counted in 2022. This is shown by an analysis by the Scientific Institute of the AOK (WIdO), which is exclusively available to the FAZ.
In terms of types of illness, the strongest declines were in outpatient-sensitive diagnoses, which can also be treated by doctors in private practice. Treatments for back pain and high blood pressure fell by more than a third. This was followed by the chronic lung disease COPD (28 percent), diabetes (21 percent) and heart failure (14 percent).
“Corona has an accelerating effect here in terms of the stronger outpatient treatment that is urgently needed in Germany,” judged WIdO Managing Director Jürgen Klauber. But he also suggested that too much was treated in the past: “In the case of individual diagnoses, given the large and ongoing slumps, the reduction of oversupply should also play a role.”
Have you had too many surgeries?
An example is tonsil surgery with minus 35 percent. There may have been less inflammation because of the stricter hygiene, but it is also conceivable that an excessive amount of surgery was previously carried out: “Analysis shows that these interventions were often carried out in the past without indication in accordance with the guidelines.” The WIdO has the data from 220,000 patients evaluated between February 2020 and the end of September 2022.
The numbers are important for the hospital reform planned by Health Minister Karl Lauterbach (SPD). “Increased outpatient treatment, especially for chronic illnesses, is a goal of the reform that we fully support,” said Carola Reimann, chairwoman of the AOK federal association, of the FAZ bring about a fundamental change.”
There is an opportunity to limit the work of the clinics “to the services that really need inpatient treatment”. Reimann praised the idea of setting up special hospitals for basic care. They could take care of elderly and chronically ill patients and “do not need expensive full inpatient treatment in a specialized department with high-tech equipment and highly specialized professionals”.
Objection from the hospital association
The hospital association DKG contradicted the interpretation. It is “highly speculative” to conclude that outpatient treatment is overdue from falling clinical cases. “There are no facts at all that prove that these patients have found an adequate treatment alternative in the outpatient sector in a timely manner,” said DKG boss Gerald Gass of the FAZ and currently, due to the staff shortages in the hospitals, have led to a significant undersupply with some long-term negative effects on the health of the population.”
In fact, there were also worrying developments in the decline in therapy in 2022, including 16 percent fewer colon cancer surgeries – possibly due to a lack of preventive care. Treatment for heart attacks and strokes decreased by 13 and 11 percent, respectively. All three values were even higher than in previous years. Another finding: 2022 did not show as many serious or fatal Covid 19 diseases as before. However, almost every second ventilated patient died.
WIdO Managing Director Klauber confirmed: “Corona had the German clinics firmly under control in the third year of the pandemic, but for different reasons than in 2020 and 2021.” In the first two years, beds for corona patients were kept free. In 2022, the Omikron variant then caused “enormous staff shortages”.